I think it's sad for women in England that they're going to have to wait longer

Dr Anne Szarewski

Pilot schemes have shown that the LBC can reduce the rate of inconclusive smears by 6% a year.

The technique also reduces workload and increases productivity in laboratories by cutting the number of inadequate smears and allowing samples to be examined more quickly.

The Scottish Executive is investing �2.75m to introduce the test north of the border.

Assessment

However, it will not be introduced in England and Wales until it has been assessed by the National Institute for Clinical Excellence (NICE).

As things stand Nice is not due to issue an appraisal of the system until May 2003 - and there is no guarantee that it will be approved.

Introducing LBC nationally could cost the health service an estimated �25bn.

Dr Anne Szarewski, clinical consultant at Cancer Research UK, said: "I think it's sad for women in England that they're going to have to wait longer when it is likely that LBC will be shown to worthwhile in England as well."

She added that the system could be used as a one-stop test for the sexually transmitted organism chlamydia, cases of which have increased sharply in recent years.

She said: "It is costly but from a purely service side it's a good idea.

"A lot of women will be spared the unnecessary anxiety of being recalled because of inadequate smears, plus there are add on benefits."

Preservative

As with the old system, an LBC smear sample is taken using either a plastic spatula or brush sampler to collect cells from the cervix.

Traditionally, cells are then prepared by a nurse on a slide before being sent to the laboratory.

But an LBC sample is immediately transferred to a preservative fluid before going to the lab, which reduces the chances of the smear being damaged.

LBC would mean that around 24,000 Scottish women each year would not be required to undergo a repeat smear.

More accurate smear results should also result in a fall of up to 3,600 inappropriate referrals for colposcopy to investigate abnormalities each year.

A spokeswoman for the NHS Breast and Cervical Cancer Screening Programme said: "The Scottish pilots finished a lot earlier than the English ones.

"We are now having to wait for the outcome of the English pilots and the Nice evaluation.

"Basically the system cannot be introduced in England and Wales until Nice produces its independent appraisal."

A NICE spokeswoman said: "The review date for the guidance is May 2003, and it would be wrong to second guess the outcome of that."